Are you really ready for health behavior change?? Client and Helping Professional considerations:

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Understanding Health Behavior Change:



Prochaska and DiClemente proposed that people make behavioral changes through a series of stages known as Precontemplation, Contemplation, Preparation, Action and Maintenance with the possibility of Relapse.  It is very important to note that Relapse is a natural part of the change process and can occur at any stage. 

                                             
While the Stages of Change Model has been utilized widely to attain a better understanding of smoking cessation and smoking relapse behavior, it can be applied across a range of problem health behaviors including behaviors associated with weight control, high-fat diets, condom use, sunscreen use, safer sex, adolescent delinquent behavior, mammography and other health screenings, and exercise.

Stages of Change:



Precontemplation: is the stage in the process of behavior change in which an individual is not thinking about changing his/her behavior.
Contemplation:  is the stage in the process of behavior change in which the individual starts to engage in information seeking, re-evaluates the self and the problem behavior, and seriously considers making a change in the next six months.
Preparation: is the stage in the process of behavior change in which individuals are planning to make the desired healthful change in the next 30 days and have made an attempt in the past year. 
Action: is the stage in the process of behavior change in which the individual displays overt modification of the risk behavior but is also vulnerable to relapse.
Maintenance: is the stage in the process of behavior change in which the individual continues to display the adaptive behavior change for a period ranging from six months to three years or more.




My own work in the area of smoking cessation examined  psychosocial factors measured via psychosocial scales. These psychosocial factors were predictive of positive stage movement through the stages of change from a problem behavior to the adoption of a healthier behavior.  The Psychosocial scales measured Health Beliefs (feelings of susceptibility), Attitudes Towards Health (willingness to change), Social Support (perceived emotional support), Self- Efficacy (perceived ability to carry out action), Health Locus of Control (feelings of control over health), and Mental Distress (short term feelings of well-being or lack thereof over the past month). 

Findings indicated that when clients are accurately staged according to their readiness to change along the Stages of Change spectrum,  psychosocial characteristics were either predictive of progressive stage movement through the stages of change or, in some instances,  the likelihood of regression. 

                                               


Implications for Positive Behavior Change:

  •  Both identification of client psychosocial characteristics as well as determination of the correct stage of readiness are instrumental in facilitating progressive stage movements towards the desired health behavior.
  • Motivational approaches are both appropriate and more effective during the earlier stages of the change process. Therefore, in the precontemplation and contemplation stages, it is suggested that the helping professional should practice empathy and also provide choices to the client in an effort to enhance motivation towards considering behavior change.
  • In addition, by providing the client with a number of options, the client is given a chance to select an approach that meets his or her specific needs and situation. 
  • For difficult cases who are also identified as having low psychosocial resources, it is advised to arrange a group session which would enable clients with similar challenges to share and learn from the experiences of each other.
  • Health beliefs, attitudes toward health, and self-efficacy have been found to be significant predictors of progressive stage movement during the earlier stages of the change process.
  • Health locus of control, level of mental distress and self-efficacy as well were found to be important during the later stages of the change process.
  • Taking the levels of clients' psychosocial resources into consideration as indicated by their scores on selected psychosocial scales as well as their stage of readiness to quit can facilitate greater progress during the change process. 
  • Incorporating motivational techniques during the earlier stages of the change process can particularly assist clients in moving from precontemplation to contemplation as well as in preparing them to take action.

Lorna C. Hylledig  EdD., MSPH., R.D/N., L.D/N


Comments

  1. Ashley ArcherFebruary 27, 2023 at 8:09 PM

    I’m definitely a lover of the social sciences, so I thoroughly enjoyed reading about the psychosocial approach to health behavioral change that you’ve described!

    ReplyDelete
    Replies
    1. Let’s Talk Health and Nutrition with Dr. HFebruary 28, 2023 at 4:58 AM

      Thank you, Ashley! We cannot attain permanent and effective positive health behavior change in the physical dimension without consideration of the determinants of health and other factors which may be potential barriers to change in the clients' other dimensions of health--environmental, social, emotional, financial, occupational, intellectual, and spiritual. From my own research, it was so enlightening to observe that the psychosocial characteristics shared---mental distress, health beliefs, attitudes towards health, health locus of control and self-efficacy---had a significant impact on the clients' ability to move progressively from one stage in the change process to another.

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